An "Almost Vegan" Speaks Out: Me and the Plant-Based Diet

I never liked eggs as a young child, and I stopped eating dairy and red meat last year when I was told by others that those foods were inflammatory. 

My Asian doctor threw up his hands when I told him that I'm an "almost vegan." Instead of saying "oy vey" (the Yiddush expression for "here comes trouble"), he mumbled something under his breath that was the equivalent, I believe, because I'm taking a blood thinner, and "almost vegan" didn't sit well with him. 

Blood thinner people have to watch their intake of Vitamin K and have blood tests scheduled on a regular basis. Too much Vitamin K can cause clotting, too little causes bleeding when you're taking Coumadin. The main thing is, take Vitamin K in a consistent way, the same foods every day, which is at best a challenge. (There are other blood thinners, but if bleeding start to happen, they don't have an antidote that's prevalent, but they're working on it. Any day now, the hematologist said).

So, returning to the story, all that was left was chicken and pork. And let's not forget sheep who are killed by the age of one to give us lamb chops, and I don't eat lamb because I saw a special once on lambs' torturous slaughter. For fuck's sake. 

All of this change in diet happened because I'm reading (son recommended) the book "How Not to Die," a documented tome by Dr. Michael Greger (available on Amazon) which, by the way, recently become an international best-seller. In the book, he gives descriptions of chicken and pork who are confined in tiny spaces and brutally slaughtered that would send waves of chills down anybody's spine. And don't forget the feces that get mixed up in the annihilation of these animals. So I'm there, hating all of it.

So welcome to a Plant-Based Diet. I guess I'm a vegan now although not exclusively. I'd say an "almost vegan." I want to say it's for moral reasons that I eat no meat or the by-products of animals that produce eggs and dairy. Rather, as a stroke survivor, it makes utterly no sense not to be lean. It would mean lugging around that extra weight and I don't want to do that anymore. And plant-based means weight loss.

To define the difference between vegans and vegetarians, although all vegans tend to follow the same set of clear cut rules by eating nothing that came from an animal, there are a few different types of vegetarian diets.

Lacto-ovo from the Latin words for milk and egg, is the most common type of vegetarian. As the name suggests, people who follow this diet eat dairy products and eggs but avoid meat, poultry, and seafood.

Lacto vegetarians eat dairy products but no eggs, meat, poultry or seafood.

Ovo vegetarians eat eggs but no dairy products, meat, poultry or seafood.

Pescatarians eat fish and other seafood but no poultry or meat and they may eat eggs and dairy.

Flexitarians eat meat at most once a week and they may eat eggs and dairy.

Then there are vegans who choose this restrictive diet for moral reasons about animal welfare. But I would be dishonest in saying so. I am an "almost vegan" because the real reason is, I'm allergic to fur and woolen fabric, and leather next to my skin makes me overheated. And I am an "almost vegan" because make-up products tested on animals first doesn't seem to bother me. 

Vegans also avoid honey, but I don't. Plantbasednews.org says, "Farmers are known to replace the honey they remove from a hive with a sugar substitute, which is substantially worse for the bees' health. The cheap sugar replacer lacks the nutrients, fats, and vitamins that honey has. This unethical practice prompts honey bees to overwork themselves to replace the missing honey.

"Beekkepers will clip the queen bees' wings to prevent them from leaving the hive and producing a new colony elsewhere - which would slash productivity and profit. Queen bees are also often artificially inseminated." Horrible, yet don't think about it enough at the moment. 

Also, it’s super important to ask how restaurant food is made before ordering it. Many soups, stock, and sauces that don’t seem to contain meat are made with chicken or beef broth (or maybe you subscribe to the if-you-don't-see-it, it-isn't-there philosophy that is my roll at times when I'm super-tired to just ask), and fried foods may be made with lard, known as fat from a pig. Eew-wee-oooh! I never forget to ask.

These vegan/vegetarian diets can be very nutritious, but v/v need to be recognize nutrition deficiencies like the following:  dairy products are a primary source of calcium and vitamin D, so vegans and vegetarians should eat lots of dark leafy greens that are rich in calcium and take supplements to replace Vitamin D. 

Also, dark leafy greens have Vitamin K, and lots of it, which if I eat them consistently, through trial and error, the blood tests will eventually be fine. Plus no cranberries ever, a small amount of blueberries, very limited dark chocolate, soy in extreme moderation, and so many more restrictions. Thus, the Asian doctor's reaction. 

Better yet, read the book to discover nutritional replacement alternatives, like B12 which is necessary to prevent anemia and found in animal products.

Vegetables, fruit, grains, nuts, and beans will fit for both diets depending on how they're prepared. Good thing I like all of them. 

People always ask me, with a doubtful look on their faces, "How about needed protein found in meat and dairy?" That's an easy one. There are peas, lentils, brown rice, and quinoa, for example, that are packed with protein. Forget the soy and hemp seeds. Too much of them and they could be lethal.

Taking Coumadin, blood thinner royale, and getting enough Vitamin K are complicated, but I like challenges. This challenge, also getting the consistent amount of Vitamin K as an "almost vegan," is a tough one, but it's do-able. I feel a new sense of vigor and energy on this plant-based diet. Plant-based just makes sense, at least to me.

Is an Aneurysm a Type of Stroke? Is a Stroke a Type of Aneurysm? WHICH IS IT!?! aka I Hate Disorders with No Symptoms!

I used to say stroke, then aneurysm for variety, but the more I heard people talking about one or the other, I realized that I had made a mistake. So to have my dear readers not make the same mistake, an aneurysm is different from a stroke, yet commonalities exist.

Flint Rehab says, "The big difference is that a stroke is an event and an aneurysm is a condition." That didn't make sense to me because you can have multiple strokes and then that would be a condition. But the pictures from Flint tell all you would need to know.

Explaining a stroke:

A stroke occurs when the supply of blood in the brain is blocked by either a clogged artery (ischemic stroke) or burst artery (hemorrhagic stroke).

When a stroke occurs, it deprives brain cells of oxygen-rich blood (https://stroketales.blogspot.com/2019/06/oxygen-getting-to-brain-cells-is.html) and leads to brain damage. As a result, a stroke can result in massive or minor symptoms and requires immediate medical attention!

Explaining in aneurysm:

A saccular aneurysms – also known as “berry aneurysms” – involves a large bulge in an artery that resembles a berry hanging off a branch.

A fusiform aneurysms involves the artery bulging in all directions.

You can have an aneurysm without any symptoms. However, once an aneurysm in the brain ruptures, it leads to a hemorrhagic stroke (the commonality between stroke and aneurysm), which is likely where the confusion between the two conditions occur.

Although an aneurysm can occur in the abdomen or chest, I am talking about cerebral aneurysm which occurs in the brain. 

A stroke requires immediate attention.

The aneurysm is different because unruptured brain aneurysm doesn’t usually cause any symptoms. But if the aneurysm grows larger or ruptures, then symptoms occur.

According to the Mayo Clinic, symptoms of an unruptured brain aneurysm are varied:

• Dizziness
• Mild or severe headache
• Blurred or double vision
• Seizures

Risk factors that develop over time include:

• Older age
• Cigarette smoking
• High blood pressure (hypertension)
• Drug abuse, particularly the use of cocaine
• Heavy alcohol consumption

Sometimes, a brain aneurysm can leak a small amount of blood, which is called a sentinel bleed which results in the worst headache ever. Emergency medical attention is needed because it often leads to a severe rupture.

An aneurysm rupture can mean bleeding into the brain, thus a hemorrhagic stroke. It's called a subarachnoid hemorrhage, the symptoms of which are:

• Drooping eyelids
• Loss of consciousness
• Sudden, severe headache
• Neck stiffness
• Blurry or double vision
• Sensitivity to light
• Seizures
• Nausea or vomiting

Treatment for stroke and aneurysm are different, but there is some overlap.

Here’s the main difference between how a stroke and an aneurysm differ:

• When a stroke is caused by a blood clot, that is, ischemic stroke, treatment usually involves a clot-dissolving drug called tPA or surgery to remove the clot.
• When stroke is caused by a burst artery, that is, hemorrhagic stroke, treatment often involves surgery.
• While small aneurysms are often benign and left alone, large aneurysm are often surgically treated in order to prevent rupturing.

Four different options for unruptured brain aneurysms are:

Aneurysm clipping

When a large berry aneurysm is found in the brain, doctors may recommend an aneurysm clipping, where a tiny metal clip is surgically placed to isolate the aneurysm and prevent rupturing.

Coil embolization

Endovascular flow diversion

When a clipping or coiling won’t suffice, an endovascular flow diversion may be implemented. During this surgery, a tightly woven mesh tube is inserted into the artery to prevent blood from entering the aneurysm.

Artery occlusion and bypass

When an aneurysm isn’t accessible or too damaged, a bypass may be performed. During this surgery, tiny metal clips are used to completely block flow from the artery. The blood flow is then rerouted via vessel grafting by taking an artery from somewhere else and adding it to the problem area.

Treatment for a ruptured brain aneurysm, that is, a hemorrhagic stroke: 

A ruptured brain aneurysm which is a hemorrhagic stroke is usually treated with a craniotomy, where a surgeon removes part of the skull and clips the ruptured artery to stop the bleeding. Once the aneurysm is treated and normal blood flow is restored in the brain, stroke rehabilitation can begin to recover from the side effects caused by a brain bleed.

And this from the Mayo Clinic. Most brain aneurysms, however, don't rupture, create health problems or cause symptoms. Such aneurysms are often detected during tests for other conditions.

Oh, great. Another thing to worry about: an undetected, unruptured brain aneurysm with no symptoms. 

I'm suddenly reminded of what Julius Caesar once said: "As a rule, men worry more about what they can't see than about what they can." 

You got that right, Julius! 

Stroke Survivors: Too Much Body Weight More Than Likely Means Failed Rehab Expectations at Some Point

Do you yo-yo with your weight after stroke? Many stroke survivors, sooner or later, are bored of being homebodies and venture out with a caregiver, or not, to find some excitement at the pharmacy or grocery store. I ventured out, albeit not alone, to even find some thrill at the doctor's office. But alas, there weren't any thrills anywhere and I went home and ate out of boredom, the one thing I shouldn't have done.

Now I follow My Fitness Pal app downloaded on the phone, for the past 90 days, once again, to take off those unsightly pounds. I lost 19 pounds so far, with a "decade and a half" (15 lbs) more to go, but I am at a plateau, not being able to really exercise like I used to in those sweat-generating sessions. I bought an exercise bike that my son and his girlfriend are supposed to put together after I sell the chair and cabinet that's blocking the space. But I digress.

Anyway, until then, when I finally have the bike assembled, the Fitness Pal diet goes on, and whether you like reality or not, it's a fact that stroke and excess body fat are a bad combination.

I can tell when I am heavier. I have a harder time standing up from the low couch, usually achieving it by the second or third time. When I was thinner, the first time. Thus, you may get to a point in Rehab in the Overweight range or higher where, try as you might, you just can't do the exercises fully, getting breathless or overly fatigued, or both as I did.

To get whether you roughly (the operative word) weigh too much, Johnny Wright, former Head of Outreach at ReNew Bariatrics, shared this information with me. (See the chart below).

In order to determine your Body Mass Index, which is the popular way to tell if you are overweight:

Take how much you weigh and divide it by your height in inches times 2. This feature is called squaring, in this case your height, and multiply the total by 703.

Example: If I weighed 140 lbs. and divided it by my inches which is 65 inches times 2, would read:

140      =  .033         .033 x 703 = 23.2    which makes me in the Normal Weight range.
65x65

My height is the same, my weight a little bit higher, so the Normal Weight range is what I'm seeking.

But there are exceptions, so take these numbers in perspective:

If you are a body builder, muscle is more dense than fat and is far better and healthier than body fat.

If you have heart disease, diabetes, or any disorder in your gene pool that is listed in the chart, it may be better if you try for the Normal Weight range.

If you are at the age of 60 or above, your metabolism slows down as you age, so take that into account.

IF YOUR DOCTOR TELLS YOU DIFFERENTLY, FOLLOW THE DOCTOR'S PLANS.

If you're already in the Normal Weight range or lower, congratulations. And if you're trying to get into the Normal Weight range, kudos for trying.

It Is What It Is: Stroke Pain Gets Some Relief From CBD! aka You Don't Have to Smoke Weed to Achieve Comfort in Most Cases

Stay with me here. Long albeit necessary introduction ahead regarding the first source in English of "It is what it is." The earliest known written reference dates back to 1949 when the phrase appeared in a column written by J. E. Lawrence in the Nebraska State Journal:

"New land is harsh, and vigorous, and sturdy. It scorns evidence of weakness. There is nothing of sham or hypocrisy in it. It is what it is, without an apology."

It is what it is. I use that expression, too, a lot, regarding my  stroke pain. I always have a mild sensation, rarely severe, in my affected leg, so much so that now I don't even regard it as pain, just an annoying tingling. It's become the way it is (see, again), at times forgetting about it. And now I discovered relief. Welcome to the world of Cannabidiol!

I attribute the following information to Harvard Medical School:

Cannabidiol (CBD) has been recently covered in the media, so what exactly is CBD? CBD stands for cannabidiol, and it is the second most prevalent of the active ingredients of cannabis (marijuana). While CBD is an essential component of medical marijuana, it is gotten directly from the hemp plant, which is directly related to the marijuana plant. While CBD is a component of marijuana (one of hundreds), by itself it does not cause a “high.” 

According to a report from the World Health Organization, “In humans, CBD exhibits no effects indicative of any abuse or dependence potential. To date, there is no evidence of public health-related problems associated with the use of pure CBD.” 

CBD is easily available in most parts of the United States, though its exact "legal" status is in limbo. All 50 states have laws legalizing CBD with varying degrees of restriction, and while the federal government still considers CBD in the same class as marijuana, it doesn’t make a habit to enforce against it. In December 2015, the FDA eased the regulatory requirements to allow researchers to conduct CBD trials. 

Forbes says once associated into the arena of Controlled Substances Act for nearly 50 years alongside heroin, LSD, and marijuana (or cannabis), the non-psychoactive relative of marijuana--CBD--cannot get you stoned like weed, and it is defined by the federal government as containing not more than 0.3 percent THC, the "getting high" part of cannabis. 

In numerous studies, CBD was able to reduce the number of child and adult seizures, in some cases stopping them totally. Recently, the FDA approved the first time ever, cannabis-derived medicine for these conditions, Epidiolex, which contains CBD.

CBD relieves anxiety, insomnia, (with both falling asleep and staying asleep), and pain, and a variety of other conditions seen in the chart above.

The side effects of CBD include nausea, fatigue, and irritability, and can increase the level in your blood of the blood thinner Coumadin, resulting in bleeding. 

A significant safety concern with CBD is that it is primarily sold as a supplement, and the FDA does not regulate the safety and purity of supplements. However, it can also be added to a number of non-edibles and used topically, like balms and lotions. 

The researchers need more data, but CBD may be proven an option for managing anxiety, insomnia, pain, and other ailments. It's true that CBD is currently mostly available as an unregulated supplement, and it's difficult to know exactly what you are getting. If you decide to try CBD, talk with your doctor to make sure it won’t have an adverse effect on other medications you are taking.

Natural Stacks says that CBD comes in many forms:

Products containing CBD oil are widely available, even on Amazon. You can find it, for example, in capsules, creams, or gummies.

As mentioned before, anyone can make a CBD supplement without formal regulation or testing. Even though the cannabis industry is thriving, until there is official regulation and control of CBD, you should do your research to have an absolutely clear knowledge of what you’re buying. 

Ask questions to the vendor:

• Is this a full-spectrum or pure CBD oil, an extract, or wax?
• What is the actual quantity of CBD in the product?
• Can you give me the name of the company that produced this product?
• Do you have any documents to show that this product is effective and safe?
• Do you offer exchanges or refunds if I feel that the product is not helping me?  

A trusted company should be able to produce a Certificate of Authenticity on the label, provided by an accredited laboratory.

There's also CBD wax which comes in different forms, and may be called shatter, live resin, crumble, or budder. It’s manufactured by treating the extract so that it becomes crystallized.  

Dabbing CBD wax is exceptionally potent and can provide instant relief from problems, but you should use it cautiously as it's concentrated. 

I can't ingest (take by mouth) CBD because I'm on the blood thinner Coumadin, but I've used a CBD lotion locally from Amazon called Hemp Cream 1000 which helps my leg temporarily from that awful tingling. Again, check with your doctor before using any CBD products. I did, and now constant relief! 

Can Brain-Injured People Ever Achieve Prolonged Happiness, aka MY List Doesn't Have to Be YOUR List

People who tell you that they experience complete happiness every hour of every day are delusional. For example: If you sent someone a virus warning by forwarding the email so they could see what it looked like and forgot to remove the infected attachment, or if some barista screwed up the order and you got espresso--which you drank--instead of decaffeinated, or if you put on mismatched socks because it was early in the morning and still dark outside, and you had to endure working like that in the office all day, there's a "shit" or "wtf" or something like it in there somewhere, even if you don't say it out loud.

Come on. That's life, and it gets tough sometimes. It's not supposed to be perfect. But what about the brain injured, including stroke, who have more good reasons for having a sub-par day. What about them? 

Without further ado, here is my list for achieving happiness  as a stroke survivor, in no particular order because they each make me smile--and yes, for a prolonged while. 

1. Listening to or playing music  

Debbie Hampton, the creator of the site The Best Brain Possible (https://www.thebestbrainpossible.com), wrote, "Research shows that listening to music can reduce anxiety, depression, blood pressure, and pain as well as improve sleep quality, mood, memory, increase some cognitive functions, enhance learning and ward off the effects of brain aging." She continued to say that music stimulates your whole brain because music is structural, mathematical, and architectural based on connections between one note and the next. 

[Just a sidenote: I am now in a band now and I feel one of the happiest moments ever while I am playing the keyboard, (even with only the left hand).]

2. Having a good hair day

If you can remember, though it was long, long ago, there weren't any blow dryers or Moroccan oil to tame one's hair. As a result of that time, I sometimes was known as frizzy headed. But now, with blow dryer and oil in hand, I can even stand in the drizzle and my hair, though it would change into gentle curls, wouldn't get frizzy. So...good hair day ranks in the top 10.

3. Getting "Shares" on Facebook

To think that I've said something that matters to other people gives me joy. I haven't counted, but the posts on my blog, The Tales of a Stroke Patient and More, occasionally get shared which means the posts are shared with their friends, which means those people who shared my posts thought it important enough for all of their friends to observe.  

4. Trying a new meal 

I like try new to try new recipes at home and that makes me happy if it meets the requirements. I can't use a knife with only one hand so the recipe has to contain bite-sized pieces that I could munch on or sandwiches that I can hold. For example, my assistant bakes chicken (I don't like the deli stuff) and, when it's finished, slices it up with a teaspoon of barbecue sauce drizzled over the chicken, and puts it on low carb wheat bread. The remainder she freezes, wrapping them individually in tin foil. Ask me in the Comments section for other recipes if you can't use a knife.

5. Walking faster with my quad cane

It's a difficult line to draw. I do not want to jeopardize safety by walking too fast, yet I walk too slow for fear of going too fast. So how fast is too fast? 

In the study Determinants of Walking Function After Stroke: Differences by Deficit Severity," Dr. Shawnna L. Patterson et al found that "balance, cardiovascular fitness, and paretic [having paralysis] leg strength are all important factors involved in determining a person’s long and short-distance walking function after stroke. Balance is more important in those with more severe gait deficits, whereas cardiovascular fitness plays a greater role in those with milder deficits." 

I want both--balance and cardiovascular. So trial and error will not be looked by me as a drudge but rather as an adventure in walking.

6. Watching human-like animal behavior 

I'm healthily addicted--and happy--when I see ordinary animals doing extraordinary things. In the image above, Tori, the Indonesian Orangutan, goes to her zoo keepers when she has a tantrum if she doesn’t get her daily fix! 

And then there's Abe, my son's cat, who eats corn on the cob if my son holds the cob on both ends. Munch, munch, goes Abe without pausing. Hilarious!

7. Finishing sentences using the right words

It brings me great happiness when I can finish a sentence on my own! I have aphasia, a communication disorder that in my case is finding the right word, usually the last word. "It's so, er, um," I would say in the beginning of the disorder post-stroke, struggling to finish the sentence. It's improving, but I'm working tediously to fix it by looking up every word obsessively that's new to me or getting a different slant on a word already known. It's a mental workout. I tell people who want to finish my sentence in a nice way to fuck off. And to think that I used to speak for a living!

8. Taking a long shower

I love a warm shower to the point of smiling. Dr. David Greuner, surgical director of NYC Surgical Associates, says, "Generally speaking, the ideal shower is a warm, five to ten minute shower. Hot showers are great when you’re sick to help moisturize the nasal passages and help decongest you." And most people know that a hot shower can also ease aching in sore muscles (which I always have). 

9. Making peace of mind my priority

When my sons are happy and healthy simultaneously, when I'm not falling, when I have money left at the end of the month, when my frozen-to-microwave chicken sandwiches didn't run out before a marketing trip, when all my plants are bug free, I have peace of mind. And that make me happy.

10. Joining hands around the globe for world peace

Not gonna happen tomorrow, or next week either. But when it does, you'll see me smiling broadly. 

Write about your list in the Comments section and I'll feature it in the blog!

Or maybe you don't have any list. In that case, please get on it. In my opinion, things that make you happy are to be known and celebrated.

Stroke Survivors: R U OK? and More--Conversations About Suicide

Hang with me here. It's time. I want talk about something which is taboo in most social circles. It's kind of more like a one-to-one conversation. The topic? Suicide. I know many--a husband who had a loving wife and children, three friend's nephews, a distraught colleague, and so many more who committed the end-of-life drama prematurely. 

R U OK? has an organization that addresses just that. I wrote to them and here is their reply:  

"At the moment, R U OK? operates only in Australia out of a single national office in Sydney. We are currently developing a formal international health promotion partner framework, which will follow on from an international trademarking process. This process is taking some time and isn’t finalised as yet.

"Ideally R U OK? is seeking to expand this initiative internationally with suitable organisations interested and capable of being the central point of contact and health promotion partner for the R U OK? campaign within their countries. Until this happens - anyone interested in promoting the R U OK? message, you may download and use the existing resources from the R U OK? website (www.ruok.org.au) to promote R U OK? within your internal environment only.

"Similarly, you may share existing R U OK? social media, video and other content through your own channels. The R U OK? logo is trademarked, so no changes may be made to the logo. No changes or alterations may be made to the content, unless you change language to be culturally relevant or appropriate. We also recommend that you provide links or information of localised help/health services within your region. [Sorry, Australia. Not too much here in America].

"It’s critical that any organisations or individuals understand and respect R U OK?’s positioning and role as an early intervention campaign, within the suicide prevention health promotion space."

R U OK?’s mission is a world where we’re all connected and are protected from suicide and to inspire and empower everyone to meaningfully connect with people around them and support anyone struggling with life.

R U OK offers a 4-steps plan to a conversation: 
Ask ‘R U OK?’
Listen
Encourage Action
Check-in/Follow-up

'How to Ask’ page is located at http://www.ruok.org.au/how-to-ask.

At home in America, Representative Susan Wild, a Congresswoman, gave this impassioned speech to her colleagues that cried out for more measures regarding mental health. She, and her family and friends, too, were a victim of her husband's unsuspecting suicide. 

https://www.cnn.com/videos/politics/2019/06/27/susan-wild-partner-suicide-kerry-acker-speech-sot-vpx.cnn

“Routine screening of suicidal ideation after stroke, especially targeting subjects with specific characteristics, is needed to plan pharmacological and psychosocial interventions aimed at reducing suicide risk,” Dr. Francesco Bartoli, MD, PhD, University of Milano Bicocca (Monza, Italy), and colleagues said.

But here is the twist in suicide: Stroke survivors are more than twice as likely (learned opinions say even higher) to attempt suicide within a decade of their stroke than non-stroke patients, according to a nationwide study of more than two million Taiwanese adults.

The Neurology Times write that though the illness is an immense global presence and the most common cause of disability worldwide, cultures handle stroke diagnoses in different ways, Tomor Harnod, MD, PhD, and colleagues wrote in the Journal of the American Heart Association. In developed Western countries like the U.S., stroke patients are usually highly intolerant of their disability, which has led to increased rates of suicidal ideations and attempts in those populations.

“In different countries, cultural heritage and socioeconomic status would usually influence a patient with disability thinking about a suicide attempt,” the authors wrote. “Ethnic and cultural differences from Western countries may make Asian people more tolerant of their impairment, dependence or disability in daily life than their European or American counterparts.”

The National Institutes of Health in conjunction with American Academy of Neurology completed a study that will amaze you.

Headed by Swedish researchers in the remarkably morose study entitled "Poststroke suicide attempts and completed suicides: A socioeconomic and nationwide perspective," the researchers found the following:

This nationwide cohort study included stroke patients from Riksstroke (the Swedish Stroke Register) from 2001 to 2012. We used personal identification numbers to link the Riksstroke data with other national registers. Suicide attempts were identified by a record of hospital admission for intentional self-harm (ICD-10: X60-X84), and completed suicides were identified in the national Cause of Death Register. We used multiple Cox regression [explanation: method for investigating the effect of several variables upon the time a specified event takes to happen] to analyze time from stroke onset to first suicide attempt.

RESULTS:

We observed 220,336 stroke patients with a total follow-up time of 860,713 person-years. During follow-up, there were 1,217 suicide attempts, of which 260 were fatal. This was approximately double the rate of the general Swedish population. Patients with lower education or income (hazard ratio [HR] 1.37, 95% confidence interval [CI] 1.11-1.68) for primary vs university and patients living alone (HR 1.73, 95% CI 1.52-1.97) had an increased risk of attempted suicide, and patients born outside of Europe had a lower risk compared to patients of European origin. Male sex, young age, severe stroke, and poststroke depression were other factors associated with an increased risk of attempted suicide after stroke. The risk was highest during the first 2 years after stroke.
-----

Here's a little-known fact: I contemplated suicide in the first 2 years after my stroke, but I couldn't move around too much to finalize and, the thing that made me ultimately NOT do it, was my boys would take it so hard. I couldn't do that to them. After the 2 years passed, I wanted to do it less and less. And now almost 10 years later? No suicide thoughts at all.

That's the thing with a stroke. You get better over time, but the waiting is abhorrent, so much so that you might think about ending it all at the beginning. But just thinking about it, if you think about suicide at all, is enough for most of us.